Yeungnam Univ J Med.  2019 May;36(2):92-98. 10.12701/yujm.2019.00185.

Forefoot disorders and conservative treatment

Affiliations
  • 1Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.
  • 2Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea. wheel633@gmail.com

Abstract

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.

Keyword

Conservative treatment; Forefoot disorder; Insole; Orthosis; Shoes

MeSH Terms

Animals
Congenital Abnormalities
Foot
Foot Orthoses
Gait
Hallux
Hallux Limitus
Hallux Rigidus
Hallux Valgus
Hammer Toe Syndrome
Head
Hoof and Claw
Humans
Joints
Metatarsal Bones
Metatarsalgia
Metatarsophalangeal Joint
Neuroma
Orthotic Devices
Quality of Life
Shoes
Splints
Toes
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